P0321 Early improvement of mental health is associated with long-term disease remission in Ulcerative Colitis

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Abstract Background Emerging evidence underscore the critical role of mental health in managing ulcerative colitis. However, the potential impact of early mental health improvement on long-term therapeutic outcomes remains poorly understood. This study aimed to explore the association between early mental health improvements and long-term disease remission. Methods This was a post hoc analysis using data from the SELECTION trial (NCT02914522) involving 381 patients treated with filgotinib. Mental health was assessed using the mental health subscale of the 36-item Short-Form Survey. Endoscopic, clinical, and histologic outcomes were assessed at week 58. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Receiver operating characteristic curves, combined with bootstrap resampling, were employed to determine the mental health response threshold. Results Early mental health improvements at week 10 were significantly associated with disease remission at week 58. After adjusting for potential confounders, the aOR of mental health improvements was 1.03 (95% CI: 1.00–1.06) for endoscopic remission, 1.03 (95% CI: 1.01–1.05) for clinical remission, 1.03 (95% CI: 1.01–1.05) for histologic remission, and 1.04 (95% CI: 1.01–1.07) for disease clearance at week 58. Patients who exhibited a mental health response at week 10 (defined as an increase in the mental health subscale score of ≥7.85) were more likely to achieve long-term endoscopic remission (aOR 2.67, 95% CI: 1.43–5.25), clinical remission (aOR 1.91, 95% CI: 1.22–2.99), histologic remission (aOR 1.98, 95% CI: 1.27–3.12), and disease clearance (aOR 3.48, 95% CI: 1.74–7.50). Additionally, incorporating mental health response assessment along with clinical remission significantly enhanced outcome predictions. Specifically, patients with only clinical remission at week 10 were approximately half as likely to achieve week-58 endoscopic remission (aOR 0.45, 95% CI: 0.21–0.91) compared to those who attained both mental health response and clinical remission. Conclusion Early mental health improvements independently predicted long-term disease remission in ulcerative colitis. Integrating mental health assessments into the management strategies may provide valuable insights beyond physical symptoms.